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Anaplastic Lymphoma Kinase (ALK)-positive Tumors
Anaplastic Lymphoma Kinase (ALK)-positive Tumors
- Source :
- American Journal of Clinical Oncology
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Supplemental Digital Content is available in the text.<br />Introduction: Anaplastic lymphoma kinase (ALK) gene rearrangements are observed in about 4% to 8% non–small cell lung cancer (NSCLC). ALK+ tumors have been associated with increased pleural and pericardial disease. Our primary objective was to determine the uncommon sites of metastasis of ALK+ NSCLC. Secondary objectives included study of coexisting mutations and factors impacting survival of ALK+ NSCLC. Methods: All patients with metastatic ALK+ NSCLC at the City of Hope Cancer Center in Duarte, California from 2010 to 2017 were selected for retrospective chart review. The demographic variables were collected. The molecular statuses of patients were evaluated through commercially available platforms for next-generation sequencing. Three-dimensional volumetric images were generated for the primary lesion and different sites of metastasis. Results: Sixty two patients with ALK+ NSCLC were identified from 2010 to 2017. The median age was 59 with 36 (58%) female individuals and only 20 (32%) smokers. Twenty four patients had uncommon sites of metastasis which were thyroid, soft tissue, chest and abdominal wall, spleen, peritoneum, omentum, kidney, and ovary. Common characteristics of the primary lesions were right upper lobe location (N=23 [37%]), oval shape (N=22 [35%]), irregular margins (N=26 [42%]), solid lesions (N=27 [44%]), presence of pleural contact or effusion (N=22 [35%]). Twenty four patients had next-generation sequencing testing which showed coexisting mutations such as TP53 (N=8), EGFR (N=5), KRAS (N=3). Patients with uncommon sites of metastasis had a decreased median survival compared with common sites (39 vs. 82 m, P=0.046). Conclusion: In NSCLC, ALK rearrangements may not be mutually exclusive mutations and can present with unique radiographic patterns. Patients with uncommon sites of metastasis may have worse outcomes.
- Subjects :
- Adult
Male
Cancer Research
Lung Neoplasms
Radiography
Adenocarcinoma of Lung
Original Articles: Thoracic
Metastasis
03 medical and health sciences
non–small cell lung cancer
0302 clinical medicine
Carcinoma, Non-Small-Cell Lung
hemic and lymphatic diseases
Biomarkers, Tumor
genomics
Carcinoma
Humans
Anaplastic lymphoma kinase
Medicine
Anaplastic Lymphoma Kinase
030212 general & internal medicine
Neoplasm Metastasis
ALK-positive NSCLC
Survival rate
Aged
Retrospective Studies
Aged, 80 and over
Lung
business.industry
ALK-Positive
Middle Aged
respiratory system
Prognosis
medicine.disease
respiratory tract diseases
Survival Rate
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Mutation
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Cancer research
Adenocarcinoma
Female
Tomography, X-Ray Computed
business
uncommon sites of metastases
Follow-Up Studies
Subjects
Details
- ISSN :
- 02773732
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- American Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....cd21ba5579d6d75b622da60cbb3341a2
- Full Text :
- https://doi.org/10.1097/coc.0000000000000508